Dr. Martin believes that industry-sponsored booklets with positive testimonials about a drug unfairly influence a patient’s decision. Further, other patient information sheets included with prescriptions at the pharmacy also fall short of serving the patient because they lack information about specific benefits and include long lists of side effects without sorting clinically important ones from others less important, he says.
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“They have been criticized for not providing data on how well a drug works, leading consumers to overestimate disease risk, treatment benefits, and side effects,” states the article.
The authors conclude that pharm booklets, such as the one used in the study, could lead to biased appraisals of a drug’s benefits and risks.
“The results of our study provide further evidence that the choice architecture in the pharm booklet contained powerful, persuasive content that may lead patients to develop inaccurate beliefs about the efficacy or safety of the treatment, and it undermines their decision-making autonomy,” conclude the authors. “From a societal viewpoint, these pharm booklets could lead to the overutilization of recommended medications by nudging patients toward adopting proposed commercial products without a critical consideration of the drug attributes.”
A neutral decision aid gives rheumatologists the outline of a script to engage patients in a conversation about initiating a high-stakes medication, advises Dr. Martin.
“You don’t have to follow it exactly, but it defines a reproducible process of education and decision support that covers essential areas of content as well as the steps of a shared decision process,” says Dr. Martin.
Catherine Kolonko is a medical writer based in Oregon.
- Martin R, Enck R, Tellinghuisen D, et al. Comparison of the effects of a pharmaceutical industry decision guide and decision aids on patient choice to intensify therapy in rheumatoid arthritis. Med Decis Making. 2017 Jul;37(5):577–588.
Note: The paper’s authors note that Amgen provided the Enbrel Decision Guide booklets at no cost and that the drugmaker was not involved in patient selection, data collection or analysis.